UNPUBLISHED
UNITED STATES COURT OF APPEALS
FOR THE FOURTH CIRCUIT
No. 15-2456
ELENA TERESA JONES,
Plaintiff - Appellant,
v.
NANCY A. BERRYHILL, Acting Commissioner of Social Security,
Defendant - Appellee.
Appeal from the United States District Court for the District of Maryland, at Greenbelt.
Thomas M. DiGirolamo, Magistrate Judge. (8:14-cv-01814-TMD)
Argued: January 26, 2017 Decided: March 14, 2017
Before WILKINSON, NIEMEYER, and KEENAN, Circuit Judges.
Affirmed by unpublished per curiam opinion.
ARGUED: Dana Wayne Duncan, DUNCAN DISABILITY LAW, S.C., Wisconsin
Rapids, Wisconsin, for Appellant. David Nathaniel Mervis, SOCIAL SECURITY
ADMINISTRATION, Baltimore, Maryland, for Appellee. ON BRIEF: Rod J.
Rosenstein, United States Attorney, Benjamin B. Prevas, Special Assistant United States
Attorney, OFFICE OF THE UNITED STATES ATTORNEY, Baltimore, Maryland, for
Appellee.
Unpublished opinions are not binding precedent in this circuit.
PER CURIAM:
In this appeal, Elena Jones challenges the district court’s judgment upholding the
decision of the Social Security Administration denying her application for disability
benefits and supplemental security income. Jones argues that the administrative law
judge (ALJ) failed to consider all relevant evidence in concluding that Jones’
impairments did not meet or equal those of Listing 1.04, the regulation identifying
disorders of the spine that merit a conclusive presumption of disability and an award of
benefits. See 20 C.F.R. pt. 404, subpt. P, app. 1 § 1.04; Radford v. Colvin, 734 F.3d 288,
291 (4th Cir. 2013). Jones also argues that the ALJ failed to give a sufficient explanation
for assigning little weight to the report of Brandon Soule, a physician assistant who
examined her.
We conclude that the ALJ sufficiently explained his reasoning and that substantial
evidence supports the ALJ’s conclusions. Accordingly, we affirm the district court’s
judgment.
I.
We begin with a discussion of the legal and procedural requirements governing
claims for social security disability benefits or for supplemental security income on the
basis of disability. An ALJ evaluating whether a claimant is disabled follows a
sequential five-step process outlined in the regulations. See 20 C.F.R. § 404.1520(a)(4).
The ALJ evaluates, in sequence, (1) whether the applicant is engaged in substantial
gainful activity, (2) the medical severity and duration of any impairments, (3) whether
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those impairments meet or equal an enumerated “listing” in the regulations, (4) the
applicant’s residual functional capacity (RFC) to perform past relevant work, and (5) the
applicant’s ability to adjust to other work in light of her RFC. Id. In the present case,
Jones challenges the ALJ’s analysis of the “listings” in Step 3 and the RFC at Steps 4 and
5.
II.
Jones is 50 years old and previously has worked as a receptionist and in other
administrative jobs. Her medical record shows that she has a history of back pain and
other spinal issues. Jones has been diagnosed with disc degeneration, disc herniation,
sciatica, and lumbago. She also has difficulty walking, and uses a cane to assist with
sitting down and standing up.
In February 2011, Jones filed a claim for disability insurance benefits, alleging
that she has been unable to work since January 28, 2011, due to “arthritis of spine,”
“sciatic nerve,” and “asthma.” Her claim was denied initially and upon reconsideration.
Following the denial of her claim on reconsideration, Jones requested a hearing before an
ALJ.
After conducting a hearing, the ALJ concluded that Jones was not disabled within
the meaning of the Social Security Act. In Steps 1 and 2 of the five-step evaluation, the
ALJ determined that Jones had not engaged in substantial gainful activity since her
alleged disability onset date, and that she had severe impairments caused by asthma,
degenerative disc disease, and obesity. In Step 3, the ALJ found that Jones’ back
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impairments did not meet or medically equal the requirements of Listing 1.04 governing
spinal disorders, because “the claimant has no documented motor, sensory, or reflex loss
and is able to ambulate effectively.” See 20 C.F.R. pt. 404, subpt. P, app. 1 § 1.04.
The ALJ also found that Jones had the “residual functional capacity to perform
less than the Full Range of sedentary work.” In reaching this conclusion, the ALJ
assigned little weight to physician reports that appeared to be “mere restatement” or
“recitation” of Jones’ subjective complaints. In addition, the ALJ assigned little weight
to the opinion of certified physician assistant Brandon Soule, because Soule was “not a
medical doctor or other acceptable medical source” and, in the ALJ’s view, Soule’s
opinion was “internally inconsistent and not supported by the medical evidence of
record.” Relying on his assessment of RFC, the ALJ found that Jones could not perform
her prior work but that she could perform other jobs that exist in significant numbers in
the national economy. Based on this factual finding, the ALJ determined that Jones was
not disabled and therefore denied Jones’ claims for disability benefits and supplemental
security income.
Jones filed a complaint in district court seeking judicial review of the ALJ’s
decision. Jones and the Commissioner of Social Security consented to have the case
heard before a magistrate judge, who upheld the ALJ’s decision and entered summary
judgment in favor of the Commissioner. Jones now appeals from the district court’s
judgment.
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III.
We will affirm an ALJ’s disability determination when the ALJ applies the correct
legal standards and the ALJ’s factual findings are supported by substantial evidence.
Mascio v. Colvin, 780 F.3d 632, 634 (4th Cir. 2015). Construction of administrative
regulations, such as the listings of impairments, are questions of law that we review de
novo. Radford, 734 F.3d at 293.
A.
Jones contends that she established a conclusive presumption that she is disabled
by showing that her impairments met or equaled the symptoms in Listing 1.04A or
1.04C. She argues that the ALJ erred in failing to treat Listings 1.04A, B, and C as three
alternative grounds for satisfying Listing 1.04, and also failed to provide an adequate
explanation for his reasoning.
In response, the Commissioner contends that the ALJ identified the proper legal
standard, and gave sufficient explanation by highlighting the symptoms in the listings
that were not satisfied by Jones’ evidence. We agree with the Commissioner’s argument.
In order for a claimant to show that an impairment meets or equals a listed
impairment in Step 3, she must demonstrate that her impairment meets all the specified
criteria in the relevant listing. Sullivan v. Zebley, 493 U.S. 521, 530 (1990) (“An
impairment that manifests only some of [the] criteria, no matter how severely, does not
qualify.”) (citing SSR 83-19). However, the claimant need not show that all the listed
symptoms were present simultaneously. Radford, 734 F.3d at 293–94. Instead, a
claimant must show only that each of the listed symptoms are documented in the record,
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and that the impairment is expected to last continuously for at least 12 months. Id. at 294
(citing 20 C.F.R. § 404.1509).
To satisfy the requirements of Listing 1.04A, a claimant must show a disorder of
the spine resulting in compromise of a nerve root or the spinal cord, with “[1] neuro-
anatomic distribution of pain, [2] limitation of motion of the spine, [3] motor loss
(atrophy with associated muscle weakness or muscle weakness) accompanied by sensory
or reflex loss and, [4] if there is involvement of the lower back, positive straight-leg
raising test.” See 20 C.F.R. pt. 404, subpt. P, app. 1 § 1.04A. To establish an impairment
meeting Listing 1.04C, a claimant must show a disorder of the spine resulting in
compromise of a nerve root or the spinal cord, with “[1] [l]umbar spinal stenosis
resulting in pseudoclaudication, . . . [2] manifested by chronic nonradicular pain and
weakness, and [3] resulting in an inability to ambulate effectively.” Id. § 1.04C. An
“inability to ambulate effectively” is defined in the regulation as generally requiring two-
handed assistance with walking, such as with a two-handed walker, two crutches, or two
canes. Id. § 1.00B(2)(b)(1), (2).
We conclude that the ALJ sufficiently explained his reasoning at Step 3 by
outlining the symptoms required by the listings and by identifying the listed symptoms
that were not supported by Jones’ medical record. For example, Listing 1.04A requires a
showing of “motor loss,” and the ALJ observed that Jones had “no documented motor,
sensory, or reflex loss.” And, notably, Jones has not identified any evidence in the record
that would support such a finding of motor loss.
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Similarly, Listing 1.04C requires a showing of an “inability to ambulate
effectively,” and the ALJ observed that the record established that she “is able to
ambulate effectively.” Jones’ occasional use of a single cane does not qualify as
“inability to ambulate effectively” which, as noted above, is defined by regulation to
require two-handed assistance with walking. See 20 C.F.R. pt. 404, subpt. P, app. 1
§ 1.00B(2)(b). Accordingly, we conclude that substantial evidence supports the ALJ’s
finding that Jones’ impairments do not meet or equal Listing 1.04 under either paragraph
A or paragraph C.
B.
Jones also challenges the ALJ’s decision to assign little weight to the report of
certified physician assistant Brandon Soule. Jones argues that the ALJ did not adequately
explain his reasoning and improperly disregarded the requirement of Social Security
Ruling 06-3p that the ALJ consider statements from medical professionals who are not
licensed physicians. See SSR 06-3p, 71 Fed. Reg. 45,593 (Aug. 9, 2006).
In response, the Commissioner argues that the ALJ properly decided to assign
little weight to Soule’s opinion because that opinion was inconsistent with other evidence
in the record. Again, we agree with the Commissioner.
Under the Social Security regulations, impairments may only be established with
evidence from “acceptable medical sources,” which includes the opinions of licensed
physicians. 20 C.F.R. §§ 404.1502, 404.1513(a). Social Security Ruling 06-3p instructs
ALJs to consider evidence from sources other than “acceptable medical sources,” such as
the opinions of physician assistants, because such “other sources” evidence “may provide
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insight into the severity of the impairment(s)” established by acceptable medical sources.
SSR 06-3p, 71 Fed. Reg. at 45,594. Under this ruling, an ALJ may assign weight to the
opinions of certified physician assistants based on factors that indicate reliability and
expertise. See id. at 45,595–96. The ruling also instructs that ALJs “generally should
explain the weight given to opinions from these ‘other sources.’” Id. at 45,596.
Soule’s opinion stated that Jones’ pain was “distracting” to her ability to perform
work, that she was unable to lift more than five pounds “occasionally,” and that she could
“never” engage in gross or fine manipulation but could “occasionally” push and pull, and
climb stairs. Soule did not cite objective medical evidence in support of his opinion, and
the record before us fails to support Soule’s conclusions regarding the severity of Jones’
limitations. In addition, as the ALJ noted, Soule’s report was incomplete in parts and
appears to contain internal inconsistencies, especially regarding Jones’ degree of pain and
Soule’s lack of correlation of that pain to her physical limitations. We therefore conclude
that substantial evidence supports the ALJ’s decision to afford little weight to Soule’s
opinion, and that the ALJ adequately explained his reasoning in this regard.
IV.
For these reasons, we affirm the district court’s judgment.
AFFIRMED
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